Is Elective Surgery Safe During COVID-19?

Surgery during Covid-19 is safer at an ASC

Paul J. MacKoul, M.D., co-founder, The Center for Innovative GYN Care

This past spring, when COVID-19 was becoming widespread in some parts of the country, many people saw their elective surgeries canceled by the facilities where they were to be performed. Unless a surgery was necessary to save a life or had the potential to diagnose and improve or cure a life-threatening condition, it was suspended under a decree by many governors and state and county departments of health.

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The Risks of Waiting
Ambulatory Surgery Centers 

Caught in the middle were women experiencing severe pain and heavy bleeding from complex gynecological conditions such as uterine fibroids and endometriosis. Some saw their scheduled surgeries canceled indefinitely; others who had been debating seeing a specialist had no choice but to continue to wait until the moratorium on office visits was lifted as well.

Since then, elective surgeries in many localities have resumed — but lengthy backlogs at hospitals now present another obstacle. So does prioritizing: A hospital may first reschedule procedures that it deems more urgent over others, rather than rescheduling according to when the procedures were supposed to take place.

The Risks of Waiting for Surgery 

Even if elective surgeries are permitted where they live, some women may still be continuing to put off seeking care for their condition. Media-driven images of COVID-19 hospital patients on ventilators and accounts from overtaxed health care workers were all over social media; news outlets reported severe shortages of personal protective equipment (PPE), including masks, leading many people to view medical environments with apprehension. Women may feel that it’s simply not safe to have elective surgery right now.

Elective gynecological surgeries can and should be offered now to women whose symptoms are severe and impairing their ability to go about their normal routine.

Putting off treatment risks progression of the disease or condition, which can lead to long-term problems. For example, it may require a blood transfusion prior to surgery and, ultimately, the need for a more complex surgical procedure. This complexity can then lead to increased complications, or the need for a more invasive procedure with more pain and a much longer recovery time.

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Ambulatory Surgery Centers – A Safer Alternative 

The key to having a safer elective GYN surgery is bypassing the hospital environment and having the procedure at an ambulatory surgery center (ASC) like The Center for Innovative GYN Care. CIGC, part of the GYN ASC management company Tower Surgical Partners, is a freestanding, independent, fully equipped surgical facility dedicated to minimally invasive GYN procedures. ASCs are an excellent alternative for patients seeking elective surgeries that do not require an overnight stay, a definition that fits most GYN surgeries when they are done laparoscopically rather than via an open abdominal approach.

Ambulatory surgery centers have multiple safety advantages over hospitals:

  • ASCs do not treat COVID-19 patients.
  • Their same-day discharge model quickly gets patients back to the safety of their home.
  • Their smaller footprints are easier to keep clean and sterile.
  • Fewer people enter the facilities.

ASCs follow the latest recommendations from the Centers for Disease Control, state departments of health and leading medical associations. At CIGC TSP facilities, safety measures include:

  • State-mandated COVID testing, as required, prior to the surgical procedure. Should a patient test positive, the surgery will be rescheduled, and the patient must self-quarantine for 14 days as per CDC guidelines.
  • Screening of staff members for cold- or flu-like symptoms. They are also asked to stay home if they are sick.
  • Screening of patients upon arrival. They will be asked to reschedule if they have symptoms.
  • Enforcement of 6-foot social distancing and wearing of face masks.
  • Personal protective equipment for medical staff.
  • A request for anyone who arrived with the patient to please wait in their car when possible.
  • A reduction in the number of patients seen each day to avoid crowding.
  • Frequent sanitizing and cleaning of the waiting room, exam rooms, equipment and other items.

Because ambulatory surgery centers allow elective surgeries to be performed in a safer environment than hospitals, and because they play an important role in reducing surgery backlogs so patients can get the care they need more quickly, ASCs are poised to become the default avenue for elective surgeries in the United States — whether a pandemic exists or not.

Why CIGC? 

CIGC is dedicated to providing information and materials for women to help navigate the complicated health care system. The CIGC founders, minimally invasive GN surgical specialists Paul MacKoul, M.D. and Natalya Danilyants, M.D., developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind.

Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed more than 9,000 complex GYN procedures and are constantly finding better ways to improve outcomes for patients.

About the Author

Paul J. MacKoul, M.D.
Dr. Paul J. MacKoul, co-founder of The Center for Innovative GYN Care, is fellowship-trained in GYN oncology and specializes exclusively in minimally invasive GYN surgery. He co-developed the advanced laparoscopic techniques DualPortGYN® and LAAM® with Natalya Danilyants, M.D.; both procedures have unmatched outcomes compared to other methods of minimally invasive GYN surgery.

Dr. MacKoul, who is also CEO of the GYN ASC management company Tower Surgical Partners, graduated from medical school at Tufts University, then completed his residency in OBGYN at the University of Maryland. His fellowship in gynecologic oncology was at the University of North Carolina.

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